EPA/AFLONursery staff members in hard hats taking youngsters, all wearing yellow hoods, to an evacuation site in Tokyo's Ikebukuro area, following Japan's severe earthquake and tsunami in March. Japanese child psychologists recently met with specialists at UMDNJ in Stratford to work on exercises for children experiencing post-traumatic stress disorder in the wake of the natural disaster.

The gush of a showerhead.

The trickle of a single raindrop on a little girl's face.

For a young child from the devastated eastern coastline of Japan, either may be enough to trigger a cry of "Tsunami! Tsunami!"

And the unseen wounds of the youngest survivors of the inundated island nation are only going to get worse, say child psychologists Miyako Shirakawa and Satomi Kameoka, who expect that even the children who emerged physically unscathed will be dealing for years with post-traumatic stress syndrome.

"We expect longtime support will be needed," said Kameoka, clinical director of the Osaka Prefectural Mental Health Center.

Along with six of their colleagues, Kameoka and Shirakawa met recently with experts in the treating of traumatic stress at the Child Abuse Research and Education Service, or CARES Institute, at the University of Medicine and Dentistry of New Jersey in Stratford.

Esther Deblinger, the co-director of the institute, said the children of Japan, much like the survivors of the storms that overwhelmed the Gulf Coast in 2005, are experiencing situations — including the loss of homes, the death of loved ones and relocation to unfamiliar surroundings — that are unimaginable to most.

"Without help, even small children may experience post-traumatic stress symptoms that can remain with them throughout their lives," the psychologist said.

One technique, which Deblinger helped develop and shared with her Japanese visitors, is to use role-playing, games and analysis of harrowing first-person abuse narratives — what they call trauma-focused cognitive behavior therapy. It relies on gradually guiding children and parents to confront traumatic events head-on.

Deblinger said they have been able to use the technique to help children who have suffered a variety of traumatic experiences.

Although originally developed for sexually abused children, Deblinger said the technique has applications for natural disaster victims like those of Japan’s children. In 2006, she made multiple trips to the Gulf Coast region in the wake of Hurricane Katrina to provide training to mental health agencies.

The trauma therapy method has garnered recognition as a standard in the last decade. In 2001 it was given an "exemplary program award" by the U.S. Department of Health and Human Services.

Shirakawa, who specializes in sexual abuse, said the trauma she has been seeing as a mental health supervisor of the Japan East Earthquake Support Center in Iwate Prefecture — a hard-hit area — called for something more than the techniques she has used in the past.